Relapse rates and work productivity among patients receiving disease modifying therapy (dmt) for multiple sclerosis (ms)

Abstract

Background: Real-world studies suggest that natalizumab results in lower relapse rate versus other MS DMTs and improves work productivity. Objective: To compare relapse rates and work productivity using Work Productivity and Impairment (WPAI) questionnaire between MS patients treated by platform therapies, oral therapies or natalizumab. Methods: RRMS patients receiving natalizumab, platform or oral therapies for greater than 12 months were identified from the 2015 Adelphi MS Disease Specific Programme, a global (U.S., U.K., Spain, Italy, France and Germany) cross-sectional study that obtained patient consent/approval. Average treatment effects (ATEs) for 1113 patients (156 natalizumab, 711 platform, 246 oral) were estimated and adjusted utilizing a propensity score generated from age, gender, EDSS score at current treatment initiation, line-of-therapy, BMI, duration of current treatment, time sinceMS diagnosis, and number of comorbid conditions. Physician-reported relapses in the previous 12 months and work productivity were compared across treatments. Results: Relapse and WPAI data were available for 934 (122 natalizumab, 617 platform, 195 oral) and 222 (34 natalizumab, 137 platform, 51 oral) patients, respectively. Natalizumab patients suffered fewer relapses than platform (ATE =−0.21 vs. 0.48, p = 0.020) and oral therapy patients (ATE =−0.14 vs. 0.45, p = 0.075). Patients receiving natalizumab reported significantly less presenteeism, i.e., attending work while sick) than those receiving platform (ATE =−10.16% vs. 19.26%, p = 0.001) or oral therapies (ATE = −8.28% vs. 22.65%, p = 0.0018). Treatment was not associated with less overall work impairment. Conclusion: Treatment with natalizumab compared to platform or oral therapies was associated with a lower relapse rate and a significant reduction in impairment at work or presenteeism. Sponsored by Biogen.